Individual provider Active NPI

Magdalena Nowak, DDS

  • Dentist
  • Springfield, MA
National Provider Identifier
1386999134
Registry record updated Nov 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1856068 Issued in MA
Practice address
1795 Main St
Suite 215
Springfield, MA 01103-1077
Phone
(413) 733-6651
NPI assigned
Jul 18, 2012
Last updated
Nov 25, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1856068 MA Primary

Addresses

Primary practice location

1795 Main St
Suite 215
Springfield, MA 01103-1077

Mailing address

14 Audubon Rd Apt 224
Wakefield, MA 01880-1333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150629000490 MA Order and Referring Only - DentistPractitioner - Dentist 4486966835

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1856068MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Nowak Family Dental LLC Past Accepting new patients
Baystate Dental Practice, LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543104000000",
    "number": "1386999134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 AUDUBON RD APT 224",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018801333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1795 MAIN ST",
            "address_2": "SUITE 215",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011031077",
            "telephone_number": "413-733-6651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWAK",
        "first_name": "MAGDALENA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-18",
        "last_updated": "2018-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1856068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.